BRITISH STROKE RESEARCH GROUP

British Stroke Research Group

MEMBERSHIP APPLICATION FORM

Please send the completed form to:

Penny Irwin

Stroke Programme Co-ordinator

Clinical Effectiveness & Evaluation Unit

Royal College of Physicians

11 St Andrewís Place

London NW1 4LE

Tel: 020 7935 1174 x335

Fax: 020 7487 3988 e-mail: penny.irwin@rcplondon.ac.uk

Dear

Thank you for your enquiry. Enclosed is some information about the BSRG. The annual membership fee is £5.00 (by standing order or £7.50 by cheque), which covers the costs of the annual meeting. Paid up members are also entitled to receive free on request a copy of the membership list of all other BSRG members.

You can pay by cheque, which entitles you to go to the next annual meeting. We would like to encourage payments by standing order, which is much more convenient. Using a standing order, £5.00 is deducted from your account on the 1st day of the year and this covers the meeting held at the end of January of that year. To pay by standing order, please complete the attached mandate, including the address of your bank, and send it with your completed membership application form to me.

Please complete the section below. This information will be held on computer.

Surname:

Forename(s):

Correspondence address:

Profession or area of expertise:

Research interests (be brief):

Method of payment (delete as appropriate):

I enclose a completed standing order mandate YES/NO

I enclose a cheque payable to the British Stroke Research Group for £7.50 YES/NO

BRITISH STROKE RESEARCH GROUP - CONSTITUTION ( 1^st April 1998)

1. Aims of BSRG

a) To provide an informal forum and source of information where people involved in stroke research may meet and exchange ideas.

b) To hold a meeting once a year.

c) To increase the quality and quantity of stroke research in the UK.

2. Joining the BSRG

The BSRG is open to anyone involved and/or interested in any aspect of stroke research. Interested people should apply to any member of the Executive Committee. Anyone who fails to attend three consecutive meetings will forfeit their automatic right to membership; anyone interested in maintaining an association with the BSRG may become a corresponding member.

3. Organisation

There will be an Executive Committee of seven members, including a Chairman, a Secretary, and a Treasurer, together with four ordinary committee members. Other BSRG members may be co-opted onto the Committee as necessary. Committee members shall hold office for three years and then be subject to re-election once. Committee members will be nominated and elected at the Annual General Meeting as necessary.

4. Finance and Annual Subscription

The BSRG will charge a membership fee of £5 per year to cover administration and part of the cost of any meeting. The charge for any meeting will be kept to a minimum simply to cover the cost of the meeting. In general speakers will not be paid, nor will any expenses be given to speakers. The Committee may propose an increase in the subscription if and when needed. This will be voted on at the AGM and accepted by a simple majority of those voting.

5. Annual Meeting

At some time during the Annual Meeting the date and place of the next meeting will be decided by the members. Once the venue has been decided, local BSRG members will be co-opted onto the Committee to help arrange and organise the meeting.

6. The BSRG Should Strive to be Informal

Presentations should be in understandable English, aiming to transmit ideas. The content of any meeting will be at the discretion of the organising committee, but may include discussions on methodology, discussions on research proposals being developed, as well as more formal presentation of data and other results.

TO: NATIONAL WESTMINSTER BANK PLC

__________________________________________Branch Standing Order Mandate

Bank

Branch Title (not address)

Sorting Code Number

Please pay

Nat West

Oxford North

60 - 16 - 07

Beneficiary's Name

Account Number

For the Credit of

British Stroke Research Group

6

6

0

2

5

3

4

6

Amount in figures

Amount in words

the sum of

£5.00

Five Pounds

Date and amount of first payment

Due Date and Frequency

1 January 2003

£5.00

Year

commencing

and thereafter every

Date and amount of last payment

£

…until you receive further notice from me/us in writing

quoting the reference

and debit my/our account accordingly

Please cancel any previous Standing Order or Direct Debit in favour of the beneficiary named above under this reference.

Special instructions:

Account to be debited

Account Number

*

Signature(s) *_________________________________________ Date ______________________________

_________________________________________

*Delete if not applicable

Address of your bank:- ____________________________________________________________________

________________________________________________________________

Note: The Bank will not undertake to:

i) make any reference to Value Added Tax or other indeterminate element

ii) advise payers address to beneficiary

iii) advise beneficiary of inability to pay

iv) request beneficiary's banker to advise beneficiary of receipt

If the amounts of the periodic payments vary they should be incorporated in a schedule overleaf NWB 1320 Rev Feb 85-1